Section of Developmental and Behavioral Sciences, The Children's Mercy Hospital, Kansas City, MO 64108, USA.
J Pediatr Surg. 2011 Jun;46(6):1121-5. doi: 10.1016/j.jpedsurg.2011.03.038.
The current study examined the impact of immediate laparoscopic surgery vs nonoperative initial management followed by interval appendectomy for appendicitis with abscess on child and family psychosocial well-being.
After obtaining Internal Review Board approval, 40 patients presenting with a perforated appendicitis and a well-formed abscess were randomized to surgical condition. Parents were asked to complete child quality of life and parenting stress ratings at presentation, at 2 weeks postadmission, and at approximately 12 weeks postadmission (2 weeks postoperation for the interval appendectomy group).
Children in the interval arm experienced trends toward poorer quality of life at 2 and 12 weeks postadmission. However, no group differences in parenting stress were observed at 2 weeks postoperation. At 12 weeks postadmission, participants in the interval condition demonstrated significant impairment in both frequency and difficulty of problems contributing to parenting distress.
Families experience significant parenting distress related to the child's functioning and disruption in the child's quality of life that may be because of the delay in fully resolving the child's medical condition. In addition, parents experience negative consequences to their own stress as a result of the delay before the child's appendectomy.
本研究探讨了对于阑尾脓肿患者，立即行腹腔镜手术与非手术初始治疗后行间隔期阑尾切除术对患儿及其家庭的社会心理健康的影响。
在获得内部审查委员会的批准后，将 40 名患有穿孔性阑尾炎和形成良好脓肿的患者随机分配至手术组。在就诊时、入院后 2 周以及大约入院后 12 周（间隔期阑尾切除术组在术后 2 周），父母被要求完成儿童生活质量和育儿压力评分。
间隔组患儿在入院后 2 周和 12 周时的生活质量呈下降趋势。然而，在术后 2 周时，两组之间的育儿压力没有差异。在入院后 12 周时，间隔组的参与者在导致育儿困扰的问题的频率和困难程度上均表现出显著的损害。
家庭经历了与孩子功能障碍和生活质量中断相关的重大育儿困扰，这可能是因为孩子的病情延迟得到完全解决。此外，由于孩子的阑尾切除术延迟，父母自身的压力也会受到负面影响。
